Pediatric aphakic glaucoma.

Three cases of pediatric open-angle aphakic glaucoma are presented. These patients had congenital cataracts extracted by the extracapsular techniques of phacofragmentation or irrigation and aspiration. Each required a secondary membranectomy and had development of glaucoma six to 25 months after cataract extraction. Surgical therapy was required in each case of glaucoma, and multiple procedures were necessary. Visual outcome in the involved eye was less than 20/400. The cause of the open-angle aphakic glaucoma is most likely secondary to damage to the trabecular meshwork initiated by uveitis and lens remnants. We urge ophthalmologists who perform pediatric cataract surgery to use phacofragmentation of the cataract and posterior capsule and anterior vitrectomy with vitrectomy instrumentation. This should reduce the incidence of secondary membranes and glaucoma. Ophthalmologists should be aware of this complication and the necessity of prolonged patient follow-up.